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  MIG Update – August 24, 2026

Psychological Diagnosis & Pain Interplay Determinative in MIG Escape  

In this week’s edition, we review a MIG removal case where the Applicant advanced that her psychological diagnosis and physical pain were interdependent. The Tribunal considered whether the clinical interviews, consistent behavioral observations, and qualitative credibility assessments outweigh formal psychometric validity scales and ultimately, whether a persistent pain cycle caused sufficient functional decline to render the disputed treatment plans reasonable and necessary.

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Factor – Psychological Diagnosis and Pain Interplay

In Campbell v. Intact Insurance Company, (24-006514) Sharon Campbell was involved in an accident on January 21, 2022 and sought removal from the MIG based on both a psychological impairment and chronic pain syndrome, claiming entitlement to six disputed Treatment Plans totaling $14,617.81.

The Applicant’s Position

Campbell relied on the January 24, 2023 report of psychologist Dr. Brunshaw. Based on a clinical evaluation, Dr. Brunshaw diagnosed her with Adjustment Disorder with Mixed Anxiety and Depressed Mood, alongside a Moderate-to-Severe Specific Phobia (Situational Type: Vehicular). She also relied on the CNRs from Markham Health Network, Humber River Hospital, and her GP Dr. Wong, spanning from January 2022 through mid-2024, documenting persistent pain complaints since the accident. Further the diagnosis of a benign soft tissue myofascial injury rendered by Dr. Mian’s IE July 17, 2024 2.5 years post accident was indicative of her chronic condition.

The core of her argument is based on how these clinical findings demonstrate substantial functional impairment specifically, the phobia directly causes severe travel anxiety as both a driver and passenger, while her depressed mood causes sleep disruption, appetite changes, weight gain, fatigue, social withdrawal, and a loss of motivation for daily activities. Further she asserts the psychological report’s conclusion that her mental health deterioration is directly tied to her ongoing physical pain.

The Respondent’s Position

Intact argues that Campbell sustained no accident-related psychological impairment, relying on two IEs. First on the July 20, 2023 assessment of psychologist Dr. Lotfalizadeh, whose opinion should be preferred because he administered a Structured Inventory of Malingered Symptomatology (SIMS) test to screen for symptom exaggeration, a psychometric measure notably absent from Dr. Brunshaw’s evaluation. The second, a subsequent September 11, 2024 IE report by psychologist Dr. Naisi reaching the same conclusion.

Regarding the claim for chronic pain it relied on GP Dr. Loritz’s July 2022 IE report and December 2022 paper review. It also relied on GP Dr. Mian’s July 2024 IE report, which diagnosed her with benign soft tissue myofascial injuries.

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The Tribunal found:

• • Dr. Brunshaw’s psychological diagnosis was preferred over the IE assessors because it was grounded in a comprehensive clinical interview, self-report questionnaires, and explicit behavioral observations confirming Campbell’s credibility, which was further supported by her family doctor’s early clinical referral for psychological screening in June 2022.
  • Campbell established a chronic condition with complaints lingering far past the normal healing timeframe. She met three AMA Guides criteria for chronic pain:
  • Validated ongoing use of prescribed pain-relief drugs.
    
  • Attending clinic appointments at least twice per month for over 16 months established functional dependence.
    
  • Psychosocial symptoms were linked directly to the validated psychological disorder.
    
  • Intact’s own IE physician Dr. Mian diagnosed “soft tissue injuries” 2.5 years post-accident which effectively established a chronic condition.
  • All but the initial treatment plan for a psychological assessment were found reasonable and necessary.

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